As Introduced

126th General Assembly
Regular Session
S. B. No. 87

Senator Wachtmann 

To amend sections 3721.011 and 3721.04 of the Revised 1
Code regarding the provision of hospice care in 2
residential care facilities.3


       Section 1. That sections 3721.011 and 3721.04 of the Revised 4
Code be amended to read as follows:5

       Sec. 3721.011.  (A) In addition to providing accommodations,6
supervision, and personal care services to its residents, a7
residential care facility may provide skilled nursing care as8

       (1) Supervision of special diets;10

       (2) Application of dressings, in accordance with rules11
adopted under section 3721.04 of the Revised Code;12

       (3) Providing for theSubject to division (B)(1) of this 13
section, administration of medication to residents, to the extent 14
authorized under division (B)(1) of this section;15

       (4) Subject to division (C) of this section, the hospice care 16
and services specified in division (A)(1) to (10) of section 17
3712.01 of the Revised Code;18

       (5) Other skilled nursing care provided on a part-time,19
intermittent basis pursuant to division (C)(D) of this section.20

       A residential care facility may not admit or retain an21
individual requiring skilled nursing care that is not authorized22
by this section. A residential care facility may not provide23
skilled nursing care beyond the limits established by this24

       (B)(1) A residential care facility may admit orand retain an26
individual requiring medication, including biologicals, only if27
the individual's personal physician has determined in writing that28
the individual is capable of self-administering the medication or29
the facility provides for the medication to be administered to the30
individual by a home health agency certified under Title XVIII of31
the "Social Security Act," 4979 Stat. 620286 (19351965), 42 32
U.S.C.A. 3011395, as amended; a hospice care program licensed 33
under Chapter 3712. of the Revised Codepursuant to division (C) 34
of this section; or a member of the staff of the residential care35
facility who is qualified to perform medication administration.36
Medication may be administered in a residential care facility only37
by the following persons authorized by law to administer38

       (a) A registered nurse licensed under Chapter 4723. of the40
Revised Code;41

       (b) A licensed practical nurse licensed under Chapter 4723.42
of the Revised Code who holds proof of successful completion of a43
course in medication administration approved by the board of44
nursing and who administers the medication only at the direction45
of a registered nurse or a physician authorized under Chapter46
4731. of the Revised Code to practice medicine and surgery or47
osteopathic medicine and surgery;48

       (c) A physician authorized under Chapter 4731. of the Revised 49
Code to practice medicine and surgery or osteopathic medicine and 50

       (2) In assisting a resident with self-administration of52
medication, any member of the staff of a residential care facility53
may do the following:54

       (a) Remind a resident when to take medication and watch to55
ensure that the resident follows the directions on the container;56

       (b) Assist a resident by taking the medication from the57
locked area where it is stored, in accordance with rules adopted58
pursuant to section 3721.04 of the Revised Code, and handing it to59
the resident. If the resident is physically unable to open the60
container, a staff member may open the container for the resident.61

       (c) Assist a physically impaired but mentally alert resident, 62
such as a resident with arthritis, cerebral palsy, or Parkinson's 63
disease, in removing oral or topical medication from containers 64
and in consuming or applying the medication, upon request by or 65
with the consent of the resident. If a resident is physically 66
unable to place a dose of medicine to the resident's mouth without 67
spilling it, a staff member may place the dose in a container and 68
place the container to the mouth of the resident.69

       (C)(1) A residential care facility may admit and retain an 70
individual requiring the hospice care and services specified in 71
division (A)(1) to (10) of section 3712.01 of the Revised Code 72
only if the facility enters into a written agreement with a 73
hospice care program licensed under Chapter 3712. of the Revised 74
Code that provides for all of the following:75

       (a) A determination that the individual's needs can be met at 76
the residential care facility;77

       (b) Recurring determinations that the individual's needs are 78
being met at the residential care facility;79

       (c) A schedule for making the determinations required by 80
division (C)(1)(b) of this section.81

       (2) The hospice care and services specified in division 82
(A)(1) to (10) of section 3712.01 of the Revised Code may be 83
provided only by a hospice care program that is licensed under 84
Chapter 3712. of the Revised Code and enters into an agreement 85
with the residential care facility under division (C)(1) of this 86

       (D) A residential care facility may admit orand retain88
individuals who require skilled nursing care beyond the89
supervision of special diets, application of dressings, or90
administration of medicationtypes of skilled nursing care 91
specified in division (A)(1) to (4) of this section, only if the 92
care will be provided on a part-time, intermittent basis for not 93
more than a total of one hundred twenty days in any twelve-month 94
period. In accordance with Chapter 119. of the Revised Code, the 95
public health council shall adopt rules specifying what 96
constitutes the need for skilled nursing care on a part-time,97
intermittent basis. The council shall adopt rules that are 98
consistent with rules pertaining to home health care adopted by 99
the director of job and family services for the medical assistance100
medicaid program established under Chapter 5111. of the Revised 101
Code. Skilled nursing care provided pursuant to this division may 102
be provided by a home health agency certified under Title XVIII of 103
the "Social Security Act," 49 Stat. 620 (1935), 42 U.S.C.A. 301,104
as amended, a hospice care program licensed under Chapter 3712. of105
the Revised Code, or a member of the staff of a residential care 106
facility who is qualified to perform skilled nursing care.107

       A residential care facility that provides skilled nursing108
care pursuant to this division shall do both of the following:109

       (1) Evaluate each resident receiving the skilled nursing care 110
at least once every seven days to determine whether the resident 111
should be transferred to a nursing home;112

       (2) Meet the skilled nursing care needs of each resident113
receiving the care.114

       (D)(E) Notwithstanding any other provision of this chapter, a115
residential care facility in which residents receive skilled116
nursing care pursuant to this section is not a nursing home.117

       Sec. 3721.04.  (A) The public health council shall adopt and 118
publish rules governing the operation of homes, which shall have 119
uniform application throughout the state, and shall prescribe 120
standards for homes with respect to, but not limited to, the 121
following matters:122

       (1) The minimum space requirements for occupants and123
equipping of the buildings in which homes are housed so as to124
ensure healthful, safe, sanitary, and comfortable conditions for125
all residents, so long as they are not inconsistent with Chapters126
3781. and 3791. of the Revised Code or with any rules adopted by127
the board of building standards and by the state fire marshal;128

       (2) The number and qualifications of personnel, including 129
management and nursing staff, for each class of home, and the130
qualifications of nurse aides, as defined in section 3721.21 of131
the Revised Code, used by long-term care facilities, as defined in 132
that section;133

       (3) The medical, rehabilitative, and recreational services to 134
be provided by each class of home;135

       (4) Dietetic services, including but not limited to136
sanitation, nutritional adequacy, and palatability of food;137

       (5) The personal and social services to be provided by each 138
class of home;139

       (6) The business and accounting practices to be followed and 140
the type of patient and business records to be kept by such homes;141

       (7) The operation of adult day-care programs provided by and 142
on the same site as homes licensed under this chapter;143

       (8) The standards and procedures to be followed by 144
residential care facilities in admitting and retaining a resident 145
who requires the application of dressings, including requirements 146
for charting and evaluating on a weekly basis;147

       (9) The requirements for conducting weekly evaluations of148
residents receiving skilled nursing care in residential care 149

       (B) The public health council may adopt whatever additional 151
rules are necessary to carry out or enforce the provisions of 152
sections 3721.01 to 3721.09 and 3721.99 of the Revised Code.153

       (C) The following apply to the public health council when154
adopting rules under division (A)(2) of this section regarding the 155
number and qualifications of personnel in homes:156

       (1) When adopting rules applicable to residential care 157
facilities, the public health council shall take into158
consideration the effect that the provision of personal care159
services and part-time, intermittent skilled nursing care pursuant 160
to division (C)(D) of section 3721.011 of the Revised Code may 161
have on the number of personnel needed.162

       (2) The rules prescribing qualifications of nurse aides used 163
by long-term care facilities, as those terms are defined in 164
section 3721.21 of the Revised Code, shall be no less stringent 165
than the requirements, guidelines, and procedures established by 166
the United States secretary of health and human services under 167
sections 1819 and 1919 of the "Social Security Act," 49 Stat. 620 168
(1935), 42 U.S.C.A. 301, as amended.169

       Section 2. That existing sections 3721.011 and 3721.04 of the 170
Revised Code are hereby repealed.171